Dr. Femi Olaleye, Medical Director of Optimal Cancer Care Foundation, said lung cancer is the second commonest occurring cancer in both men and women, and is by far the leading cause of cancer deaths among men and women. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. Therefore, it can be regarded as a huge public health menace. GERALDINE AKUTU reports.

Who is susceptible to having lung cancer?
Lung cancer mainly occurs in older people, with most people being diagnosed with the ailment at 65 or older. The average age at the time of diagnosis is about 70. Overall, the chance that a man will develop lung cancer in his lifetime is about 1 in 15; for a woman, the risk is about 1 in 17. These numbers include both smokers and non-smokers. The risk is much higher for smokers, while the risk is lower for non-smokers.

There are three main types of lung cancer. Knowledge of each type of cancer determines the treatment options and eventual outlook (prognosis). They are Non-Small Cell Lung, Small Cell Lung Cancer and Lung Carcinoid Tumour.

Non-Small Cell Lung Cancer is the most common type of lung cancer. About 85 percent of lung cancers are non-small cell lung cancers. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of non-small cell lung cancer.

Small cell lung cancer is also called oat cell cancer. About 10 percent to 15 percent of lung cancers are small cell lung cancers. This type of lung cancer tends to spread quickly.

Fewer than five percent of lung cancers are lung carcinoid tumours. They are also sometimes called lung neuroendocrine tumours. Most of these tumours grow slowly and rarely spread.

What are the risk factors of lung cancer?–
Some risk factors of lung cancer include, smoking, which is by far the leading risk factor for lung cancer. About 80 percent of lung cancer deaths are thought to result from smoking. The risk for lung cancer among smokers is many times higher than among non-smokers, with the risk being more if one smoked for a longer period of time and more packs a day.

Cigar smoking and pipe smoking are almost as likely to cause lung cancer as cigarette smoking. In addition, breathing in the smoke of others (called secondhand smoke or environmental tobacco smoke) can increase your risk of developing lung cancer. Secondhand smoke is thought to cause more than 7,000 deaths from lung cancer each year.

People who work with asbestos, such as in mines, mills and textile plants, are several times more likely to die of lung cancer. Lung cancer risk is much greater in workers exposed to asbestos who also smoke.
People exposed to large amounts of asbestos also have a greater risk of developing mesothelioma.

In cities, air pollution, especially near heavily trafficked roads, appears to raise the risk of lung cancer slightly.

Studies of people in parts of Southeast Asia and South America with high levels of arsenic in their drinking water have found a higher risk of lung cancer.

Also people, who have had radiation therapy to the chest for other cancers are at higher risk for lung cancer, particularly if they smoke.

Someone who has had lung cancer has a higher risk of developing another lung cancer. Brothers, sisters, and children of people who have had lung cancer may have a slightly higher risk of lung cancer themselves, especially if the relative was diagnosed at a younger age.

What are the signs and symptoms?
Most lung cancers do not cause any symptoms until they have spread, but some people with early lung cancer do have symptoms. The most common symptoms of lung cancer are a cough that does not go away or gets worse, coughing up blood or rust-colored sputum (spit or phlegm), chest pain that is often worse with deep breathing, coughing, or laughing, shortness of breath, hoarseness, weight loss and loss of appetite. Others are infections, such as bronchitis and pneumonia that don’t go away or keep coming back, new onset of wheezing.

If lung cancer spreads to distant organs, it may cause bone pain (back or hip pain), nervous system changes, such as headache, weakness or numbness of an arm or leg, dizziness, or seizures from cancer spread to the brain or spinal cord. There is also yellowing of the skin and eyes (jaundice), from cancer spread to the liver, and lumps near surface of the body, due to cancer spreading to the skin or to lymph node.

How is it diagnosed?
Tests to diagnose lung cancer may include, Imaging test. This is an X-ray image of the lungs to reveal an abnormal mass or nodule. A CT scan can reveal small lesions in the lungs that might not be detected on an X-ray. There is also Sputum cytology. If the patient has a cough and is producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells. Tissue sample (biopsy) involves taking sample of abnormal cells removed in a procedure called biopsy.

Does early detection help?
Some people with early stage lung cancer can be successfully treated. This is because tests and treatments for cancer are being studied and improved. If lung cancer is found at an earlier stage, when it is small and before it has spread, people have a better chance of living longer.

Usually, symptoms of lung cancer don’t appear until the disease is already at an advanced, non-curable stage. Even if lung cancer causes symptoms, many people may mistake them for other problems, such as an infection or long-term effects from smoking. This may delay the diagnosis. Some lung cancers are found early by accident, as a result of tests for other medical conditions.

What are the treatment options?
Treatment is dependent on location, how far it has grown or spread (the stage), how abnormal the cells look under a microscope (the grade) and the general well being of the patient.

What are the preventive measures?
Not all lung cancers can be prevented. But there are things one can do that might lower the risk, such as changing the risk factors that you can control (modifiable risk factors).

The best way to reduce the risk of lung cancer is not to smoke and to avoid breathing in other people’s smoke. If one stops smoking before a cancer develops, the damaged lung tissue gradually starts to repair itself. No matter the age or length of time of smoking, quitting may lower the risk of lung cancer and help prolong life span. Limiting exposure to secondhand smoke might also help lower the risk of lung cancer, as well as some other cancers.

Radon is an important cause of lung cancer. One can reduce exposure to radon by having the homes tested and treated, if needed.

Avoiding exposure to known cancer-causing chemicals, in the workplace and elsewhere, may also be helpful. When people work where these exposures are common, they should be kept to a minimum.

A healthy diet with lots of fruits and vegetables may also help reduce one’s risk of lung cancer. Some evidence suggests that a diet high in fruits and vegetables may help protect against lung cancer in both smokers and non-smokers. But any positive effect of fruits and vegetables on lung cancer risk would be much less than the increased risk from smoking.